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Usefulness of Standardized Uptake Values for Distinguishing Adrenal Glands with Pheochromocytoma from Normal Adrenal Glands by Use of 6-¹⁸F-Fluorodopamine PET

¹ Reproductive and Adult Endocrinology Program, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; ² Department of Endocrinology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; ³ Department of Nuclear Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland; ⁴ Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland; ⁵ Department of Diagnostic Radiology, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland; and ⁶ Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland

Correspondence: For correspondence contact: Karel Pacak, M.D, Ph.D., D.Sc., Reproductive and Adult Endocrinology Program, National Institute of Child Health and Human Development, 10 Center Dr., Bldg. 10, CRC, Room 1-E 3140, MSC 1109, Bethesda, MD 20892-1109. E-mail: karel{at}mail.nih.gov

6-¹⁸F-Fluorodopamine (¹⁸F-FDA) PET is a highly sensitive tool for the localization of pheochromocytoma (PHEO). The aim of this study was to establish cutoff values for pathologic and physiologic adrenal gland tracer uptake. Methods: ¹⁸F-FDA PET with CT coregistration was performed in 14 patients (10 men and 4 women; age [mean ± SD], 42.9 ± 13.3 y) with unilateral adrenal gland PHEO and in 13 control subjects (5 men and 8 women; age, 51.7 ± 12.5 y) without PHEO. Standardized uptake values (SUVs) were compared between adrenal glands with PHEO and normal left adrenal glands in control subjects. Results: ¹⁸F-FDA accumulation was observed in all adrenal glands with PHEO and in 6 of 13 control adrenal glands (P = 0.02). The SUV was higher in adrenal glands with PHEO (mean ± SD, 16.1 ± 6.1) than in ¹⁸F-FDA–positive control adrenal glands (7.7 ± 1.4) (P = 0.005). SUV cutoffs for distinguishing between adrenal glands with PHEO and normal adrenal glands were 7.3 (100% sensitivity) and 10.1 (100% specificity). Conclusion: The SUVs of adrenal foci on ¹⁸F-FDA PET facilitate the distinction between adrenal glands with PHEO and normal adrenal glands.

Key Words: 6-¹⁸F-fluorodopamine • pheochromocytoma • paraganglioma • PET

COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.

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